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Impact of Month of Birth on the Risk of Development of Autoimmune Addison's Disease

Lookup NU author(s): Dr Agnieszka Pazderska, Dr Anna Mitchell, Dr Catherine Napier, Dr Earn Gan, Dr Mauro Santibanez Koref, Professor Simon Pearce



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Context: The pathogenesis of autoimmune Addison's disease (AAD) is thought to be due to interplay of genetic, immune, and environmental factors. A month-of-birth effect, with increased risk for those born in autumn/winter months, has been described in autoimmune conditions such as type 1 diabetes and autoimmune thyroid disease.Objective: Month-of-birth effect was investigated in 2 independent cohorts of AAD subjects.Design, Setting, and Patients: The monthly distribution of birth in AAD patients was compared with that of the general population using the cosinor test. A total of 415 AAD subjects from the United Kingdom cohort were compared with 8 180 180 United Kingdom births, and 231 AAD subjects from the Polish cohort were compared with 2 421 384 Polish births.Main Outcome Measures: Association between month of birth and the susceptibility to AAD.Results: In the entire cohort of AAD subjects, month-of-birth distribution analysis showed significant periodicity with peak of births in December and trough in May (P = .028). Analysis of the odds ratio distribution based on month of birth in 2 cohorts of patients with AAD versus the general population revealed a December peak and May trough, and January peak and July trough, in the United Kingdom and Polish cohorts, respectively.Conclusion: For the first time, we demonstrate that month of birth exerts an effect on the risk of developing AAD, with excess risk in individuals born in winter months and a protective effect when born in the summer. Exposure to seasonal viral infections in the perinatal period, coupled with vitamin D deficiency, could lead to dysregulation of innate immunity affecting the risk of developing AAD.

Publication metadata

Author(s): Pazderska A, Fichna M, Mitchell AL, Napier CM, Gan E, Ruchala M, Santibanez-Koref M, Pearce SH

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Endocrinology & Metabolism

Year: 2016

Volume: 101

Issue: 11

Pages: 4214-4218

Print publication date: 01/11/2016

Online publication date: 30/08/2016

Acceptance date: 26/08/2016

Date deposited: 02/03/2017

ISSN (print): 0021-972X

ISSN (electronic): 1945-7197

Publisher: Endocrine Society


DOI: 10.1210/jc.2016-2392


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